First-ever list of 'worst' nursing homes released

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Federal health authorities on Thursday released a list of the nation's 54 worst performing nursing facilities. As could be expected, the first-time disclosure was instantly a hot topic in various media outlets around the country. "Special Focus Facilities" are so designated by the Centers for Medicare & Medicaid Services for repeated egregious citation records.

The 54 facilities, the poorest performing of the 128 on the SFF list, are spread across 34 states and the District of Columbia. There are three each in Florida, Georgia, Missouri and the state of Washington. Twenty-one of the 54 have spent at least 34 months on the SFF list.

Facilities on the SFF list will face twice the frequency of re-inspections as others until there is either sufficient improvement (two surveys with nothing above an "E" deficiency") or they are terminated from the Medicare and Medicaid programs, officials said. About half of the facilities during the 10-year history of the SFF list have improved quality of care sufficiently within 2.5 years, while about 1 in 6 have had funding cut off, they noted.

"I'm careful in saying they're not the worst performers, but they are chronic underperformers," said CMS Acting Administrator Kerry Weems, noting surveyor tenacity may differ from state to state. "We're hopeful this disclosure will put he right kind of pressure, helpful pressure, on the facilities."

Faced with few palatable alternatives, provider advocates, including the American Health Care Association and the Alliance for Quality Nursing Home Care, quickly praised the list's online posting. They also cautioned, however, that providers who have made significant improvement might not be acknowledged in a timely manner to avert negative publicity.

The list of 54 - which represents less than one-third of 1% of the 16,400 nursing homes overseen by CMS - can be found on the following Web site:
(Scroll through the list of downloadable documents to find the list.)